BY CHIOMA UMEHA,
Awareness and proper understanding of family
planning has been recognised to reduce maternal death among young women of reproductive
age between 15 and 49.
Data on Sexual Reproductive Health outcomes in
Nigeria stresses the importance of focusing on adolescents. At 576 maternal
death per 1,000 live births, Nigeria accounts for 14 percent of the global
burden of maternal mortality (NDHS 2013/WHO 2014).
Global evidence shows that young girls bear a higher
burden of maternal mortality and morbidity. Data shows that the average age at
sexual debut is roughly 15 years of age among adolescent mothers in Nigeria.
(NDHS 2003, 2008, 2013).
The National adolescent fertility rate in Nigeria is
122 births per 1,000 women aged 15 to 19 years. In the North Western States, it
is as high as 171 births per 1,000 women aged 15 to 19 years.
To stem this, the government of Lagos State with
support from partners and other donor agencies has put in place youth-friendly
health care centres and trained health care providers to provide friendly
services.
Despite the friendly centers, gaps that hinder youth
access to SRH in the country still exist, including poor knowledge, awareness
and absence of confidentiality in service delivery among others.
Many Lagos youths who are sexually active are not equipped with adequate information on the different method of
contraception available for use due to some barriers.
These barriers include: provider bias, the attitude of
the family planning officer, religious sentiments amongst others.
At a 3-day capacity building workshop on
Investigative Journalism organised by Pathfinder International Nigeria, in
Lagos, some Lagos based adolescents who spoke to journalists have expressed
dismay over the attitude of some family planning providers.
Some adolescents who visited Ikotun, Alimosho and
Agege youth friendly Centres complained of poor counseling, knowledge by the
family planning counselors.
According to 25-year old Halima Abdullazeez and
graduate of Business Admin said the service provider’s first question was on
her age bracket adding that “on learning, I have three boyfriends at 25, the
body language changed outside religious concerns and countenance, I was not
given an opportunity of seeing a condom or counseled properly on other options
of contraception, so, I had to leave.
Miss Abdullazeez said the family planning providers the welcome was not warm as anticipated, hence wondering if it should have been
better to have unplanned pregnancy to receive required attention at family
planning units of Public Healthcare Centre (PHC) despite being sexually active.
Another female youth, Helen Moses 22, who
acknowledged being sexually active lamented that the health service provider,
she accosted at the Hello Lagos Life planning centre, was visibly furious on
noticing she is a Catholic, did not give her required attention and courtesy
of offering her a seat or any attempt to make her relax before supposed
grilling.
Helen said that in the course of their
tensed-discussion, she understood that both female and male condoms were
available at the facility, but she was not given the female condom which she
had demanded but a male condom was offered to her.
She decided to take away the male condom
roll-of-four but concerned that at her back, she became subject of gossip.
For 20-year Ayoshe, who is a makeup artist, the PHC
centre she visited was near her community and because of their poor responses
to her questions as a teenager wanting to access family planning services, she
had to switch role from personal inquiry to on errand for her mother.
She was not shown any options of family planning but
told that for her to access any available service, must be during ovulation,
which family planning experts, Mrs. Abiola Adekoya disagreed with, even though
some pregnant women still ovulate whilst pregnant.
In response, a retired nurse Adekoya Abiola said
that these service providers in these cases were bad examples and opposite of
what they should be, especially in the area of counseling these youths by
sharing available options of contraception with them and possibly allows these
youths make an informed decision.
Mrs. Adekoya insisted that those service providers
need to be trained in the right contemporary path to help the teeming youth who
may come across them.
She posited that with the narratives aforementioned,
these youngsters may not likely return to the centres again eventually even
when they may be ready for family planning, describing it as a missed
opportunities to win for family planning and better equip the youth.
Speaking on the need to have knowledgeable family
planning providers in health care centres, the Country Director, Pathfinder
International Nigeria, Dr. Farouk Jega, said it would make a lot of difference
in the nation’s health care sector.
Dr. Jega said well-informed service providers will
bring about enormous change towards building trust in the adoption of family
planning and increasing uptake in the country and make a lot of difference.
Also, Dr. Jega said that every woman, especially in
developing economies like Nigeria deserves quality family planning information
so as to make an informed decision, stating that, “every woman deserves quality
information on family planning. Every woman no matter the age has the right to
know and access quality family planning information.
Pathfinder International Nigeria pointed out that there
should be provision of quality family planning information for families, and
mostly women, insisting that there should be no coercion on the part of women
as far as issues on family planning is concerned.
Kosi Izundu, Program Officer, Pathfinder
International while presenting a topic on ‘Youth And Adolescent Access To
Family Planning’ said the major challenges youth face in accessing family
planning are structural barriers such as laws and policies requesting parental
consent.
She added that socio-cultural barriers such as
restrictive norms and stigma around adolescents and youth sexuality and
individual barriers such as young people limited or incorrect knowledge of Sexual
Reproductive Health (SRH).
Though the government has tried in terms of policies and
laws to advance SRH, Izundu said there is the need for government to fully
implement those policies.
Abiodun Ajayi, State Coordinator, Life Planning for
Adolescents and Youths (LPAY) presented the topic: ‘Youth and Adolescent access
to family planning in Lagos State’, said the population of the State is about
23 million with young people aged 15-24 constituting over 4 million.
He said the unmet sexual and reproductive health
needs of young persons in Lagos State is very huge, adding that according to the
NDHS 2013, only 38.4 per cent of women aged 20-24, who are in marriage/union
are currently using a contraceptive method while 12.3 percent of these women
have an unmet need for family planning.
The risk according to Abiodun is that sexual
behavior among young people is leading to unplanned pregnancy, out of school and
baby dumping amongst others.
Some of the barriers to youth access to family
planning services according to him are; lack of access to adequate and accurate
life planning information and services, providers’ bias, religious doctrine as
well as policies barriers.
To tackle those issues, Abiodun said, government
should integrate youth-friendly family planning services in all PHCs that meet
their needs; community, religious and traditional leaders should speak
positively about SRH of young people; parents should engage their children on SRH
information and advocacy efforts should be made to key players by Civil Society
Organisations (CSOs).
Abiodun also urged the media to raise awareness
about LPAY/FP; inform listeners, readers and viewers about steps they can take
to protect themselves and others. It should also serve as a source of accurate LPAY/FP
information for young people; mobilise stakeholders to play their parts in
promoting FP/LPAY and regularly generate discussions on FP/LPAY.
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